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Best practice for the selection, design and implementation of UK Kidney Association guidelines: a modified Delphi
James O Burton1,2, Joseph Chilcot3, Katie Fielding4
1Department of Cardiovascular Sciences, University of Leicester, Leicester, UK jb343@le.ac.uk.
Background:
Despite research into how to effectively implement evidence-based recommendations into clinical practice, a lack of standardisation in the commissioning and development of clinical practice guidelines can lead to inconsistencies and gaps in implementation. This research aimed to ascertain how topics in kidney care worthy of guideline development within the UK should be chosen, prioritised, designed and implemented.
Methods:
Following a modified Delphi methodology, a multi-disciplinary panel of experts in kidney healthcare from across the UK developed 35 statements on the issues surrounding the selection, development and implementation of nephrology guidelines. Consensus with these statements was determined by agreement using an online survey; the consensus threshold was defined as 75% agreement.
Results:
419 responses were received. Of the 364 healthcare practitioners (HCPs), the majority had over 20 years of experience in their role (n=123) and most respondents were nephrologists (n=95). Of the 55 non-clinical respondents, the majority were people with kidney disease (n=41) and the rest were their carers or family. Participants were from across England, Northern Ireland, Scotland and Wales. Consensus between HCPs was achieved in 32/35 statements, with 28 statements reaching ≥90% agreement. Consensus between patients and patient representatives was achieved across all 20 statements, with 13/20 reaching ≥90% agreement.
Conclusions:
The current results have provided the basis for six recommendations to improve the selection, design and implementation of guidelines. Actioning these recommendations will help improve the accessibility of, and engagement with, clinical guidelines, contributing to the continuing development of best practice in UK kidney care.
Insights
Standardizing the development and implementation of kidney care guidelines in the UK is crucial. This study established consensus on selecting, designing, and implementing nephrology guidelines to improve best practices.
Area of Science:
- Nephrology
- Healthcare Policy
- Evidence-Based Medicine
Background:
- Lack of standardization in clinical practice guideline commissioning and development leads to inconsistencies in implementation.
- This research addresses the need for standardized methods in selecting, prioritizing, designing, and implementing kidney care topics for guideline development in the UK.
Purpose of the Study:
- To establish a consensus on the optimal processes for selecting, developing, and implementing clinical practice guidelines in UK kidney care.
- To identify key areas for improvement in the guideline lifecycle to enhance their effectiveness and adoption.
Main Methods:
- A modified Delphi methodology was employed, involving a multi-disciplinary panel of UK kidney healthcare experts.
- 35 statements regarding guideline selection, development, and implementation were developed and subjected to an online survey for consensus.
- Consensus was defined as 75% agreement, with higher thresholds (≥90%) also analyzed.
Main Results:
- A total of 419 responses were received from 364 healthcare practitioners and 55 patients/patient representatives across the UK.
- High levels of consensus were achieved: 32/35 statements with healthcare practitioners (28 at ≥90% agreement) and 20/20 statements with patients (13 at ≥90% agreement).
Conclusions:
- The study provides a foundation for six key recommendations to enhance guideline selection, design, and implementation in UK kidney care.
- Implementing these recommendations is expected to improve guideline accessibility and engagement, thereby advancing best practices in the field.
